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Scientific Session 12 — Efficacy/Administration/Informatics - Education

Wednesday, May 3, 2017

Abstracts 1055-2559

2559. 21st Century Gastrointestinal Fluoroscopy by the Numbers: What Should We Still Be Teaching?

Patel N*,  DiSantis D. Mayo Clinic, Jacksonville, FL

Address correspondence to N. Patel (

Objective: The purpose of the study is to analyze the nationwide trends of gastrointestinal (GI) fluoroscopic procedure volume over the past 15 years in the United States as a guide to preparing our trainees for what they will actually be doing in contemporary radiology practice.

Materials and Methods: Fifteen years of Medicare data from 2000 through 2014 were retrospectively reviewed and analyzed. The nationwide trends in the United States were extrapolated from the Medicare data for the most common GI fluoroscopic procedures, including swallow studies, esophagography examinations, upper GI studies, small bowel studies, and barium enemas. Understanding these data and the trends in GI procedure volume will help focus and guide education for radiology residents according to current radiology practices.

Results: Trends for GI fluoroscopy procedure volume have varied widely but with an overall downward trajectory. From 2000 to 2014, nationwide GI procedure volumes have decreased by 8% for swallowing studies, 13% for esophagography, 58% for single-contrast upper GI, 70% for double-contrast upper GI, 53% for small bowel studies, 83% for single-contrast barium enema, and 90% for double-contrast barium enema. Over this 15-year period, swallowing studies and esophagography have shown only a modest decrease in nationwide volumes, whereas upper GI, small bowel, and particularly barium enema studies have endured precipitous declines in overall numbers.

Conclusion: To understand and foresee future directions, it is important to analyze volume trends from the past. The past may predict our future direction and education in radiology, and historical data suggests that an emphasis in radiology fluoroscopy training should become heavily weighted above the diaphragm, stressing focus on swallowing evaluations and esophagography studies rather than upper GI, small bowel, and barium enema examinations, which have significantly decreased in frequency over time. GI fluoroscopy skills in swallow and esophagography studies will be a fundamental need in radiology practice for foreseeable decades.